American Academy of Neurology Annual Meeting 2019

The 71st American Academy of Neurology Annual Meeting (AAN) held in Philadelphia, Pennsylvania, from May 4 to May 10, 2019. The meeting delivered the latest developments in science, education, and networking in new and innovative ways to neurologists and neurology professionals.

The clinical research director of the UCSF Multiple Sclerosis Center discusses recent data on siponimod and its impact on cognitive measures in patients with secondary progressive MS, as well as results of the 3-arm ASSESS study comparing low-dose fingolimod and glatiramer acetate.

The director of the adult epilepsy center at Washington University in St. Louis spoke about the use of diazepam nasal spray in patients with epilepsy ­and detailed the advantages it offers these patients and their physicians.

The regional lead in clinical and translational neuroscience at Kaiser Permanente discussed subgroup findings from a study of pregnancy in women with MS which suggested that breastfeeding in the postpartum period can drastically decrease the risk of disease relapse.

The postdoctoral scholar at the University of California San Francisco discussed the findings from her study that gives comprehensive insight into prevalence and organ associations of vasculitic neuropathy.

The associate chief of the MS division and professor of neurology at Penn Medicine described the ongoing relationship between artificial intelligence and neurologists, and how it may evolve in the future.

The assistant professor and neurologist at the University of California San Francisco discussed how the presence of cranial autonomic symptoms (CAS) can be a predictor of the effect of Botox on chronic migraine.

The associate chief of the MS division and professor of neurology at Penn Medicine spoke to neurologist’s reliance on physical examination, and how the use of almost-rudimentary but longstanding tools allow for critical 1-on-1 time with the patient.

The regional lead in clinical and translational neuroscience at Kaiser Permanente spoke about the findings of a recent study of pregnancy in women with MS which showed no increased risk of relapse during the postpartum period.

The director emeritus of the Cleveland Clinic Lou Ruvo Center for Brain Health and vice chair of the department of brain health at the University of Nevada Las Vegas spoke about therapies under investigation for the treatment of Alzheimer disease.

The associate professor of neurology and medical director of the epilepsy monitoring unit and Penn epilepsy surgical program at the University of Pennsylvania discussed the findings of a single-center review of off-label clobazam use for patients with drug-refractory epilepsy.

The associate professor of neurology and medical director of the epilepsy monitoring unit and Penn epilepsy surgical program at the University of Pennsylvania shared insight into the prioritization of women with epilepsy who may intend to get pregnant.

The attending neurologist at the Montefiore Headache Center and assistant professor of neurology at the Albert Einstein College of Medicine spoke about preventive treament for perimenstrual-related migraine.

The staff neurologist at Cleveland Clinic’s Mellen Center for MS shared her insight into the use of telemedicine in an outpatient setting across a number of subspecialties in neurology and how it can supplement care going forward.

The director emeritus of the Cleveland Clinic Lou Ruvo Center for Brain Health and vice chair of the department of brain health at the University of Nevada Las Vegas spoke about therapies under investigation for the treatment of agitation and psychosis in Alzheimer disease.

The staff neurologist at Cleveland Clinic’s Mellen Center for MS shared her insight into the use of telemedicine in an outpatient setting across a number of subspecialties in neurology and how it can supplement care going forward.

The head of neurology at the Sunnybrook Health Sciences Centre of the University of Toronto spoke about the limited available normative sleep data, and shared insight into the findings of the meta-analysis he and colleagues conducted of more than 150 studies.

The professor of neurology at both the University of California San Francisco and King’s College, London, spoke about the results from a phase 2b/3 study evaluating atogepant for prevention of migraine.

The program director of neurology at Zucker School of Medicine, Northwell Health, reviewed the contributions of neurologist S. Weir Mitchell, MD, and how today’s neurologists can gain insights for their own practice from Mitchell’s complicated history.

The director of the Jefferson Headache Center at Jefferson University Hospital discussed the need for physicians to revisit how they treat patients with chronic migraine who have developed medication overuse headache.

The Director of the Multiple Sclerosis and Hereditary Neuropathy Centers at Seton Hall-Hackensack Meridian School of Medicine shared insight into what clinicians should know about Charcot-Marie-Tooth disease.

The chief medical officer and head of Research & Development at Ovid Therapeutics spoke about what prompted the development of this scale to measure improvement for patients with Fragile X syndrome, and possibly other conditions.

The director of the Pediatric Stroke Program at CHOP discussed the findings of a single-center study exploring the incidence of children presenting with acute arterial ischemic stroke who may have been eligible for mechanical thrombectomy.

The associate professor of neurology at Mayo Clinic spoke about the findings of a population-based cohort study seeking to investigate the incidence of levodopa-induced dyskinesia in atypical parkinsonism.

The director of the Pediatric Stroke Program at CHOP spoke about the need to improve early recognition and assessments in pediatric stroke, and how ultimately, awareness of the condition is a huge step toward achieving this goal.

The lead investigator noted that “the study results are a promising step toward having a scientifically-validated tool for clinical use that can facilitate physician-patient conversations and ultimately help to get ahead of MS progression.”

The chief medical officer of Neurocrine Biosciences spoke about how long-term data on valbenazine (Ingrezza) has helped shape the understanding of the effect tardive dyskinesia can have on patients, and how it can inform better utilization of the medication.

The assistant professor of neurology at Mount Sinai Health System spoke about the recent trend toward approaching migraine in a more holistic fashion, and the incorporation of nonpharmacologic options for patients with the chronic headache condition.

The director of Translational Research and Epilepsy Clinical Trials at NYU Langone spoke about the nuance involved in diagnosing epilepsy and the misconceptions about how seizures present in the majority of patients.

Compared to interferon beta-1a, the reduction of grey matter volume loss was greater in those treated with both doses of the oral S1P receptor modulator across all age groups, including the youngest patients at the highest risk for brain volume loss.

The investigators observed a dose-dependent reduction of mutant huntingtin concentration in the cerebrospinal fluid of patients who received HTTRX, supporting the launch of a confirmatory phase 3 trial.

The professor of neurology at the Icahn School of Medicine at Mount Sinai spoke about what’s currently known about medical marijuana’s use, how CBD fits into the conversation, and what research still needs to be done.

Although the primary end point of centrally video-rated TETRAS Performance Subscale did not achieve statistical significance, CX-8998-treated patients showed significant improvements in a number of other measurements.

The chief medical officer and head of Research & Development at Ovid Therapeutics spoke about the Visual Analog Scale that the company developed to help better understand the impact that potential treatments have on patients with Fragile X syndrome.

A 75 mg orally dissolving tablet formulation of the calcitonin gene-related peptide receptor antagonist met both co-primary end points of freedom from the patient-indicated most bothersome symptom and freedom from pain at 2 hours.

The sphingosine1-phosphate receptor modulator was shown to annualize relapse rates by more than 70% for patients switching from other disease-modifying therapies such as dimethyl fumarate; teriflunomide, and daclizumab.

The medical director of neurology and co-director of the Jane and John Justin Neurosciences Center at Cook Children’s Hospital spoke about what CBD has shown in clinical trials and how it could make an impact outside of Lennox-Gastaut and Dravet syndromes.

The treatment was efficacious in patients with AQP4-IgG-positive NMOSD, which accounts for nearly three-quarters of the population with the disorder, for which there is currently no approved treatment.

The phase 2 STARS trial was the first time in 50 years that an overall improvement in patients with Angelman syndrome was observed, in this instance with a once-daily dose of gaboxadol, also known as OV101.

The professor of neurology and director of translational research and epilepsy clinical trials at NYU Langone spoke about the results of a phase 2b open-label feasibility study of this novel delivery method for abortive seizure treatment in patients with epilepsy.

In a pair of phase 2 trials and a phase 1 study, patients with SMA types 1 and 2 treated with the gene therapy displayed a number of motor milestone achievements and a prolonged event-free survival rate.

Although animal models and early phase studies suggested some potential for the hypertension medication to slow disability progression in Parkinson disease, a phase 3 assessment showed a lack of treatment effect.

In patients with Dravet syndrome who had discontinued an average of 4 antiepileptics drugs, while taking a mean of 3, cannabidiol reduced the incidence of seizures almost in half in doses of both 10 mg/kg and 20 mg/kg per day.

Researchers found that cognitively unimpaired patients with apneas had an average of 4.5% higher levels of tau in the entorhinal cortex than those who did not have apneas, after controlling for several other factors.

While the overall link is only suggestive, new findings from a preliminary study have implied that there may be a link between sugar-sweetened beverage consumption and a higher disability status in MS.